To report the spectrum of MR findings of prostate gland treated with focal cryotherapy and focal brachytherapy. To illustrate MR imaging effectiveness in the early evaluation of post-implant dosimetry in patients treated with focal brachytherapy.

Althoght prostate cancer has been considered a heterogeneous, multifocal disease requiring whole-gland therapy, recent studies demonstrated that a proportion of cancers are unifocal, unilateral or of lower malignant potential, and focal therapy for prostate cancer is emerging as a desirable and feasible approach for low-risk, localized disease (1). The essence of focal therapy is precise targeted ablation of a small tumors, preferably minimally invasively, while preserving the remainder of the uninvolved organ (1,2,3,4,5). Cryosurgery is one option for the treatment of localized prostate cancer that...

MATERIALS AND METHODS FOCAL CRYOTHERAPY Six patients with localized prostatic carcinoma underwent Focal Cryosurgical Ablation. The planning of the treatment was based on byoptic and preoperative MR imaging evaluation of size and position of the neoplastic lesions. All cryoablation procedures were performed using four cryoprobes (SeedNet, Galil Medical) (Fig. 1). Cryoprobes were placed percutaneously, using endorectal sonography guidance, with the aid of a needle-spacing template (Fig. 1, Fig. 2). Patients were treated with hemiablation in five cases (the freezing zone enclosed half of the prostate...

DISCUSSION FOCAL CRYOTHERAPY Cryosurgery is the term used to describe tissue destruction using extreme cold temperature. The hystologic sequelae of this process are inflammatory reaction, coagulative necrosis and finally fibrosis and scarring (9). Focal cryoablation is an alternative therapy for the treatment of localized prostate cancer, that provides precise targeted ablation of small tumors, preserving the remainder of the uninvolved organ (3,4) (Fig. 16). As it is not possible to document hystopatologically the complete tissue necrosis after cryoablation, while PSA level comes out as bouncing...

Gianpiero Cardone, MD Radiology Department, San Raffaele Turro Hospital, Via Stamira d'Ancona 20 20127 Milan, Italy Tel +390226433285 Mail [email protected]

1) Eggener SE, Scardino PT, Carroll PR et al “Focal Therapy for Localized Prostate Cancer: A Critical Appraisal of Rationale and Modalities” The Journal Of Urology Vol. 178, 2260-2267, December 2007 2) Mouraviev V, Madden JF “Focal therapy for prostate cancer: pathologic basis” Current Opinion in Urology 2009, 19:161–167 3) Ellis DE. Cryosurgery as primary treatment for localized prostate cancer: a community hospital experience. Urology 60 (supplement 2a), August 2002, pp 34-39 4) Polascik TJ, Mayes JM, Mouraviev V “Nerve-sparing focal cryoablation of prostate cancer”...